The bill would replace a universal, comprehensive public service with a patchwork of competing, fragmented, often commercialised services. Social care service users, mostly living with few resources and in poor health, will be among the most seriously disadvantaged. Our experience and published reports tell us that privatised social care services often fail children, disabled people and adults. Think Southern Cross and Winterbourne View. The bill proposes boundaries for health commissioning which will not be coterminous with those for social care, making integrated health and social care more difficult. Greater private sector involvement in healthcare will result in more costly and less effective health services and greater inequalities in access to healthcare, as in the US.

The NHS plays a vital role in social integration and cohesion beyond its importance in the provision of healthcare. These damaging and wasteful proposals, which lack any electoral mandate, are causing "chaos on the ground", according to the BMA. They should be withdrawn and discussions held to return the NHS to stability as a public service, democratically accountable to parliament.Professor Paul Bywaters, Dr Julie Fish, Kate KarbanSocial Work and Health Inequalities Network